Anesthesia Specialists of Warren, LLC

Organization Active NPI Anesthesiology Physician · Phillipsburg, NJ

NPI 1104354422 · NPPES record last updated Aug 27, 2024

Key facts

NPI
1104354422
Entity type
Organization (NPI type 2)
Primary specialty
Anesthesiology Physician 207L00000X
Legal business name
ANESTHESIA SPECIALISTS OF WARREN, LLC
Practice address
185 Roseberry St
Phillipsburg, NJ 08865-1690
Phone
(610) 954-5810
NPI assigned
May 31, 2017
Organization subpart
No

Authorized official

Name
Robert Dequevedo, MD
Title
Authorized Official
Phone
(610) 954-5810

Practitioners 165

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 165

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20170809001980 NJ Part B Supplier - Clinic/Group Practice 5294006250 Receives reassigned benefits from 68 practitioners
Practice locations: Phillipsburg, NJ

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207L00000X Yes

Addresses

Primary practice location

185 Roseberry St
Phillipsburg, NJ 08865-1690

Mailing address

PO Box 327
Souderton, PA 18964-0327

Other providers in Phillipsburg, NJ

All providers in Phillipsburg, NJ · Anesthesiology Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.